Remediating EKG Education
Remediating EKG Education Lydia Norman MSPH, BSN, Rebecca Michael DNP, RN, CCRN-CSC, Rebecca Sharpe, BSN, RN, Danett Cantey, MSN, RN, CNE, CHSE, Tracy Stell BSN, RN, CNML Background/Purpose: Foundational EKG education is critical for new nurses to safely care for patients on cardiac monitoring. Initial competence, as measured by assessment, is required for new hire nurses at DUHS that care for patients on telemetry. The established competency pathway required completion of online learning modules, followed by an eight hour live taught Zoom class, followed by a 20-question assessment. This process saw approximately 50% of learners require remediation and re-testing, despite a time investment of nearly 10 hours of EKG education per learner. New hires that were not successful were required to meet with nursing educators to review missed content and re-test, requiring additional time investment from both clinical nurses and educational staff. Objectives: To increase the effectiveness of standard new hire nurse EKG education as evidenced by increased first time EKG assessment pass rates by revising pre-assessment education, condensing the live-taught class, and refining the EKG assessment while not increasing the educational time required per learner. Methods: A convenience sample of approximately 700 new hire nurse EKG assessments were reviewed for pass rates between August 2024 to February 2025. The anonymized pass rates were evaluated for baseline rate (August – October 2024), pass rate after assessment modification (October 2024 – January 2025), and pass rate after online learning and live class modification (January 2025 – February 2025). Results/Outcomes/Improvements or Evaluation: EKG pass rates improved from a baseline 48-53% to 76-80% after assessment revision. Pass rates further increased to 80-90% after module revision, and ultimately to 92% after live class revision. This is coupled with an approximately 3 hour reduction in required education time. Significance/Implications/Relevance: The improvement in EKG pass rates for new hire nurses reflects multi-faceted benefit for the health system. Improved content delivery ensured that key EKG principles were effectively conveyed to new hire nurses, equipping them with the knowledge to successfully identify and differentiate among arrhythmias. The increase in first time pass rates reduced the burden on nursing educators to remediate EKG education with unsuccessful learners. The reduced class time reduces indirect education time requirements for staff, effectively leading to cost savings for the health system. References: Kavanagh, J. M., & Dnp, P. A. S. (2021). Crisis in Competency: A Defining Moment in Nursing Education. Online Journal of Issues in Nursing, 26(1), N.PAG. https://doi.org/10.3912/OJIN.Vol26No01Man02 Lee, S., Kim, h.j., Choi, Y. et al. Effectiveness of electrocardiogram interpretation education program using mixed learning methods and webpage. BMC Med Educ 24, 1039 (2024). https://doi.org/10.1186/s12909-024-05960-8 Ng J, Christensen M. Registered nurses' knowledge and interpretation of ECG rhythms: A cross-sectional study. Nurs Crit Care. 2024 Sep;29(5):1032-1039. doi: 10.1111/nicc.13013. Epub 2023 Dec 29. PMID: 38156358.
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